Influence of psychological need satisfaction on self-neglect among patients with oral mucositis after chemoradiotherapy for head and neck cancer: The mediating roles of family resilience and psychological resilience

Objective: This study aimed to explore the relationships among family resilience, psychological resilience, psychological need satisfaction, and self-neglect, with a particular focus on analyzing the mediating roles of family resilience and psychological resilience between basic psychological need satisfaction and self-neglect. The purpose was to provide a theoretical basis and practical guidance for improving the psychological state of patients with oral mucositis (OM) after chemoradiotherapy (CRT) for head and neck cancer (HNC). Methods: This retrospective study selected OM-patients post-CRT for HNC from Affiliated Hospital of Jiangnan University between January 2022 and December 2024 as the research subjects. A total of 312 patients were surveyed using a general information questionnaire, the Basic Psychological Needs Scale (BPNS), the Scale of the Elderly Self-Neglect (SESN), the Family Resilience Questionnaire (FRQ), and the 10-item Connor-Davidson Resilience Scale (CD-RISC-10). Structural equation modeling and the Bootstrap method were used to test the mediating effects of family resilience and psychological resilience between psychological need satisfaction and self-neglect in these patients. Results: The scores of patients on the BPNS, SESN, FRQ, and CD-RISC-10 were 5.35 ± 1.05, 8.16 ± 5.607, 78.56 ± 12.50, and 23.45 ± 8.03, respectively. Statistically significant differences were found in BPNS, FRQ, and CD-RISC-10 scores based on residence, education, living situation, economic pressure, metastasis status, and complications (P < 0.05). SESN scores also showed significant differences across age, residence, education, living situation, economic pressure, metastasis, and complications (P < 0.05). Psychological need satisfaction negatively correlated with self-neglect (r = −0.462, P < 0.01) and positively with family and psychological resilience (r = 0.546 and 0.497, both P < 0.01). A structural equation model indicated good fit indices, revealing that basic psychological need satisfaction negatively impacted self-neglect, with family and psychological resilience serving as significant mediators. Conclusion: The satisfaction of basic psychological needs in OM-patients post-CRT for HNC can directly or indirectly affect their self-neglect through family resilience and psychological resilience. In daily nursing care, it is possible to avoid self-neglect in patients by meeting their basic psychological needs and enhancing their family resilience and psychological resilience.